NPI | 1639125792 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 2729-125) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP3112) |
Enumeration Date | 2006-05-26 |
Last Update Date | 2009-02-26 |